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Cited by 149Vaccine Coverage and HesitancyMobile Health and mHealth ApplicationsICT in Developing Communities

The feasibility of using mobile-phone based SMS reminders and conditional cash transfers to improve timely immunization in rural Kenya

Open access
Wakadha, Hotenzia, Chandir, Subhash, Were, Elijah Victor, Rubin, Alan, Obor, David, Levine, Orin S., Gibson, Dustin G., Odhiambo, Frank +2 more·2013·Vaccine
DOI 10.1016/j.vaccine.2012.11.093PMC PMC4603391
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Abstract

Background Demand-side strategies could contribute to achieving high and timely vaccine coverage in rural Africa, but require platforms to deliver either messages or conditional cash transfers (CCTs). We studied the feasibility of using short message services (SMS) reminders and mobile phone-based conditional cash transfers (CCTs) to reach parents in rural Western Kenya.Methods In a Health and Demographic Surveillance System (HDSS), mothers with children aged 0-3 weeks old were approached to determine who had access to a mobile phone. SMS reminders were sent three days prior to and on the scheduled day of immunization for 1st (age 6 weeks) and 2nd doses (age 10 weeks) of DTP-HepB-Hib (Pentavalent) vaccine, using open-source Rapid SMS software. Approximately $2.00 USD was sent as cash using mPESA, a mobile money transfer platform (2/3 of mothers), or airtime (1/3 of mothers) via phone if the child was vaccinated within 4 weeks of the scheduled date. Follow-up surveys were done when children reached 14 weeks of age.Results We approached 77 mothers; 72 were enrolled into the study (26% owned a phone and 74% used someone else's). Of the 63 children with known vaccination status at 14 weeks of age, 57 (90%) received pentavalent1 and 54 (86%) received pentavalent2 within 4 weeks of their scheduled date. Of the 61 mothers with follow-up surveys administered at 14 weeks of age, 55 (90%) reported having received SMS reminders. Of the 54 women who reported having received SMS reminders and answered the CCT questions on the survey, 45 (83%) reported receiving their CCT. Most (89%) of mothers in the mPESA group obtained their cash within 3 days of being sent their credit via mobile phone. All mothers stated they preferred CCTs as cash via mobile phone rather than airtime. Of the 9 participants who did not vaccinate their children at the designated clinic 2(22%) cited refusals by husbands to participate in the study.Conclusion The data show that in rural Western Kenya mobile phone-based strategies are a potentially useful platform to deliver reminders and cash transfers. Follow-up studies are needed that provide evidence for the effectiveness of these strategies in improving vaccine coverage and timeliness.

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  • Understanding causal mechanisms is particularly relevant for complex interventions such as mHealth interventions, which are implemented in vastly different healthcare settings, use various functions of mobile phones, target widely different health conditions, and are used by persons with different backgrounds, behaviors, skills, and beliefs.

    “Understanding these mechanisms is particularly relevant for complex interventions, such as mHealth interventions, which are implemented in vastly different healthcare settings (varying from rural communities [13, 14] to major university hospitals [15]), use various functions of mobile phones (from text messaging [16–18] to picture transmission [19]), target widely different health conditions (from”

    From A realist review of mobile phone-based health interventions for non-communicable disease management in sub-Saharan Africa (2017) · cites this paper as [14]

  • A significant proportion of mothers were not allowed to partake in the scheme by their husbands, identifying a major potential barrier to mHealth interventions.

    “A significant proportion of mothers, however, were not allowed to partake in the scheme by their husbands, thus identifying a major potential barrier to mHealth interventions that would need to be taken into account during an intervention's design.”

    From Assessing the impact of mHealth interventions in low- and middle-income countries – what has been shown to work? (2014) · cites this paper as [23]

  • A scheme trialled in Kenya showed that conditional cash transfers, via mobile phone, and SMS reminders, improved child vaccination rates in rural areas.

    “A scheme trialled in Kenya showed that conditional cash transfers, via mobile phone, and SMS reminders, improved child vaccination rates in rural areas (23).”

    From Assessing the impact of mHealth interventions in low- and middle-income countries – what has been shown to work? (2014) · cites this paper as [23]

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Authors
Wakadha, H., Chandir, S., Were, E. V., Rubin, A., Obor, D., Levine, O. S., Gibson, D. G., Odhiambo, F., Laserson, K. F., & Feikin, D. R.
Affiliations
  • Kenya Medical Research Institute (KE)
  • Johns Hopkins University (US)
  • Centers for Disease Control and Prevention (US)
Corresponding author
Feikin, Daniel R.
ORCID
Venue
Vaccine
Publisher
Elsevier BV
Published
2013-01
Volume
31
Issue
6
Pages
987-993
ISSN
0264-410X (ISSN-L)
DOI
10.1016/j.vaccine.2012.11.093
PMC
PMC4603391
OpenAlex
W1968021637
Cited by
149
References
37
Citations by year
2026: 4 · 2025: 11 · 2024: 10 · 2023: 11 · 2022: 10 · 2021: 11 · 2020: 8 · 2019: 17 · 2018: 13 · 2017: 18 · 2016: 13 · 2015: 6 · 2014: 14 · 2013: 3
FWCI
8.38
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Vaccine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • KEMRI
  • CDC
Topics
  • Social Sciences › Health › Vaccine Coverage and Hesitancy
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Physical Sciences › Computer Science › Information Systems › ICT in Developing Communities
Keywords
SMS reminders, conditional cash transfers, pentavalent vaccine, vaccination coverage, demand-side strategies, mobile money, rural Kenya
MeSH terms
Adolescent, Adult, Female, Humans, Immunization, Immunization Schedule, Infant, Infant, Newborn, Kenya, Male, Pilot Projects, Reimbursement, Incentive, Rural Population, Diphtheria-Tetanus-Pertussis Vaccine, Reminder Systems, Hepatitis B Vaccines, Haemophilus Vaccines, Cell Phone, Young Adult

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